Telangiectatic glomangioma is a rare blood vessel and soft tissue condition that usually appears as dark red, blue, or purple raised spots on the skin. It often begins in childhood or early adult life and can remain long term. Many living with telangiectatic glomangioma notice that some areas are tender or become more painful with pressure, cold, or minor bumps, which can be part of the early symptoms of telangiectatic glomangioma that lead people to seek care. Not everyone will have the same experience. Telangiectatic glomangioma is usually not life-threatening, and treatment often focuses on comfort and appearance with options such as monitoring, surgery, laser treatment, or other procedures for troublesome lesions.
How many people live with Telangiectatic glomangioma?
Global and U.S. prevalence estimates for telangiectatic glomangioma are not consistently reported by a single authoritative source. This is a very rare subtype of glomangioma, and major rare-disease references such as Orphanet and GeneReviews do not give a direct worldwide or U.S. count for people living with this specific subtype.
Overview
Telangiectatic glomangiomaSymptoms
Telangiectatic glomangioma usually appears as soft, dark red to blue skin spots or small lumps, often on the arms or legs. Many living with telangiectatic glomangioma notice tenderness or pain when the area is pressed or bumped.
Outlook and prognosis
Telangiectatic glomangioma is usually benign and tends to grow slowly. Many people live well with it, though pain or tenderness can flare with pressure, cold, or minor bumps. Outlook is generally very good after diagnosis and treatment, if needed.
Causes and risk factors
Telangiectatic glomangioma usually results from a change in the GLMN gene, inherited from a parent or appearing for the first time. Family history is the main risk factor. Lifestyle and environmental factors do not cause it, but trauma may make lesions more noticeable.
Genetic influences
Genetics are important in telangiectatic glomangioma, because some cases are linked to inherited changes in the GLMN gene. Many living with telangiectatic glomangioma have no known family history, so genetic testing may or may not be useful.
Diagnosis
Diagnosis of Telangiectatic glomangioma usually starts with its skin features and a clinician exam. Doctors often confirm it with imaging or a small tissue sample under a microscope. In some families, genetic tests can support the genetic diagnosis of Telangiectatic glomangioma.
Treatment and drugs
Treatment for telangiectatic glomangioma depends on size, pain, and location. Many living with telangiectatic glomangioma only need monitoring, while painful or bothersome spots can often be removed with surgery, laser treatment, or sometimes sclerotherapy.
Symptoms
Telangiectatic glomangioma usually shows up on the skin as soft red, blue, or purple spots, bumps, or thicker patches that may look like a small cluster of blood vessels near the surface. For many people with telangiectatic glomangioma, the marks are present from childhood or become more noticeable over time, and they can be tender if pressed. The early features of telangiectatic glomangioma are often skin changes rather than illness in the rest of the body. Features can vary in number, size, and location.
The lesions often look red, blue, or purple and may appear as small bumps, soft nodules, or slightly raised patches. Some have a fine network of tiny surface vessels, which can give them a more flushed or streaked look.
These areas can be sore when pressed, bumped, or rubbed by clothing. Some may find that even a small knock or leaning on the area feels more painful than expected.
There may be one lesion, but many people have several close together. Instead of one round spot, they can form a grouped or plaque-like area on the skin.
The marks can be very small or several centimeters wide, ranging from a few millimeters to more than 2.5 cm, or from under 0.25 inches to over 1 inch. One spot may be barely noticeable while another is easier to see and feel.
How people usually first notice Telangiectatic glomangioma?
How telangiectatic glomangioma is first noticed often begins with one or more small blue, purple, or dark red spots or soft bumps on the skin, usually in childhood or the teen years, though they can be present earlier and become easier to see over time. Many people with telangiectatic glomangioma first signs also notice that these areas can be tender or painful when pressed, bumped, or exposed to temperature changes, and the spots may slowly thicken or spread in the same general area rather than appearing all at once. Doctors and families often first recognize it when these clustered skin changes do not fade like a bruise and keep a characteristic bluish color, especially on the arms, legs, or trunk.
Types of Telangiectatic glomangioma
No distinct types of Telangiectatic glomangioma are widely recognized.
Can I slow down the onset of symptoms?
Probably not. There is no good evidence that lifestyle changes or medicines can meaningfully delay the start of symptoms in telangiectatic glomangioma, a rare blood-vessel-related skin growth, and things like diet, exercise, sleep, or supplements have not been shown to prevent it. Even so, getting new or painful skin spots checked early can help people living with this condition get the right care sooner, which may improve comfort even though it may not delay when symptoms begin.
What genetics can tell you about symptoms
Genetics can help explain why some people with telangiectatic glomangioma develop many spots while others have only a few, and why they may start in childhood or appear later. In families with an inherited change in the GLMN gene, these growths are often multiple and can vary a lot in size, number, color, and tenderness, even among close relatives. Genetics can suggest the overall pattern and timing, but it usually cannot predict exactly which symptoms someone will have or how bothersome they will be.
Causes and risk factors
Most telangiectatic glomangioma happens because of a change in the GLMN gene, and this change may be inherited or start new in one family member. A family history of telangiectatic glomangioma is the main risk factor, although some people develop it with no known family history. Age can make the spots or lumps more noticeable over time, and pressure or minor injury may make them hurt more. Having a gene change doesn’t mean you’ll definitely develop the condition. Lifestyle and environment do not usually cause telangiectatic glomangioma, but repeated friction or bumps can affect how visible or uncomfortable it becomes.
What are the most common causes or risk factors?
Telangiectatic glomangioma is usually linked to a change in a gene called GLMN, so the main risk factor is having a close family member with the same kind of blood-vessel growth. Some people develop it even without a family history because the gene change happens for the first time in them. There are no well-proven lifestyle, diet, or environmental risk factors, and it is not thought to be caused by anything a person did or did not do.
Environmental and biological risk factors
If you are wondering what causes telangiectatic glomangioma, doctors have not identified strong environmental or non-genetic biological risk factors. Awareness of both biological and environmental influences helps you feel prepared, but for this condition the main recognized drivers are usually local changes in blood-vessel-related tissue rather than outside exposures. No common everyday exposure has been proven to cause telangiectatic glomangioma.
Telangiectatic glomangioma is thought to start from a localized change in glomus cells and nearby small blood vessels. Because of this, doctors usually see it as arising within the affected tissue rather than from a typical outside trigger.
No consistent link has been proven between telangiectatic glomangioma and routine environmental exposures such as air pollution, radiation, or common chemicals. In most cases, there is no clear exposure history that explains why it occurs.
Genetic risk factors
These skin lesions often matter most when they show up in several family members or keep appearing over time. When people ask about the genetic causes of telangiectatic glomangioma, the main known cause is a change in the GLMN gene. People with the same risk factor can have very different experiences, so one relative may have many noticeable spots while another has only a few or none. Less often, the gene change starts for the first time in one person rather than being passed down.
GLMN gene: Most inherited telangiectatic glomangioma cases are linked to a harmful change in the GLMN gene. When this gene does not work properly, certain cells around small blood vessels can grow in an abnormal way and form these lesions.
Family history: Having a parent or close relative with telangiectatic glomangioma raises the chance of carrying the same gene change. This is especially important when several relatives have similar blue, purple, or tender skin spots.
Dominant inheritance: GLMN-related telangiectatic glomangioma is usually passed down in an autosomal dominant pattern. This means each child of an affected parent has a 1 in 2, or 50%, chance of inheriting the changed gene.
New change: Sometimes telangiectatic glomangioma happens because the genetic change begins for the first time in one person. Doctors call this a de novo change, meaning it was not inherited from either parent.
Second hit: In many people, inheriting one GLMN gene change is only part of the process. A second change in the same gene can happen later in a small group of cells, which may help explain why lesions appear in some areas but not others.
Variable pattern: The same GLMN gene change can affect family members very differently. Some may have many lesions or earlier onset, while others have only a few small spots or no obvious signs.
Lifestyle risk factors
Telangiectatic glomangioma is not caused by lifestyle habits, but daily routines can still influence pain, swelling, skin irritation, and bleeding from these vascular skin lesions. When people ask about lifestyle risk factors for telangiectatic glomangioma, the practical focus is usually on what can aggravate symptoms or trigger complications rather than what caused the condition. Habits that increase pressure, trauma, or skin stress may make lesions more uncomfortable or more likely to bleed. Supportive lifestyle choices can help reduce symptom flares and protect the affected skin.
Repeated friction, shaving cuts, scratching, or pressure on the affected area can trigger pain and make lesions bleed more easily. Protecting the skin with gentle care and avoiding unnecessary trauma may reduce irritation and tenderness.
Contact sports or activities with repeated blows, rubbing, or heavy pressure on involved skin can worsen discomfort in painful lesions. Lower-impact movement may be easier to tolerate while still supporting overall fitness and circulation.
Long periods of standing or dependent positioning can increase venous pooling and make some lesions feel more swollen or tender. Taking breaks, changing position, and elevating the affected area when possible may ease symptoms.
Excess body weight can add mechanical pressure and friction, especially for lesions on the legs, feet, or skin folds. Reducing skin stress may help limit soreness and irritation in these areas.
Risk prevention
For many living with telangiectatic glomangioma, there is usually no proven way to stop the condition itself from developing because it is often linked to an inherited tendency in blood vessel tissue. Prevention is about lowering risk, not eliminating it completely. In daily life, this mostly means reducing pain, bleeding, skin injury, and irritation, while getting new or changing spots checked early. If telangiectatic glomangioma runs in your family, medical follow-up can also help with planning and long-term skin care.
Bumps and patches can bleed or become painful after rubbing, bumps, or minor cuts, so gentle skin care and avoiding repeated friction may help. Soft clothing, protective padding during sports, and careful shaving can lower day-to-day irritation.
Many people with telangiectatic glomangioma notice symptoms flare after pressure or injury, such as a tight waistband, heavy backpack strap, or a knock to the area. Choosing looser gear and being cautious with contact activities can reduce pain and bruising.
Some may find that cold or sudden temperature changes make lesions more tender or uncomfortable. Keeping affected areas warm and avoiding extreme heat or cold can help limit symptom flare-ups.
If a spot cracks or bleeds, gentle pressure and basic wound care can help prevent ongoing bleeding and skin infection. Seek medical care if bleeding is hard to stop, happens often, or if the area becomes red, warm, or drains fluid.
Can you prevent Telangiectatic glomangioma?
No, telangiectatic glomangioma usually cannot be prevented. It is often linked to an inherited change in a gene, or it happens without a clear cause that you can control. Healthy lifestyle choices are still good for overall health, but they have not been proven to stop these growths from forming.
Transmission
Telangiectatic glomangioma is not infectious, so it does not spread through touch, kissing, sex, blood, food, or the air. When it is passed on, it happens through families: some people with telangiectatic glomangioma inherit a gene change from a parent, while others develop it without any known family history.
In families, how Telangiectatic glomangioma is inherited is usually autosomal dominant, which means each child of an affected parent has about a 1 in 2, or 50%, chance of inheriting the gene change. Even within the same family, the number, size, and timing of the skin lesions can vary a lot, so inheriting the change does not always mean the condition will look the same from one person to another.
When to test your genes
Consider genetic testing if you have multiple telangiectatic glomangiomas, lesions that began in childhood, or a family history of similar skin bumps or venous malformations. Finding a GLMN gene change can confirm the diagnosis, guide family counseling, and help distinguish this condition from look-alikes, but it usually does not change routine treatment of the lesions themselves.
Diagnosis
Telangiectatic glomangioma is usually diagnosed by combining the way the skin lesion looks with tests that confirm what kind of growth it is. Many living with telangiectatic glomangioma notice soft, dark red to blue spots or raised areas that may be tender when pressed or bumped. Getting a diagnosis is often a turning point toward answers and support. Because other blood vessel or skin growths can look similar, the diagnosis of telangiectatic glomangioma often needs careful review by a skin specialist.
Doctors first look closely at the size, color, shape, and distribution of the spots or nodules. The pattern can offer important clues, especially when lesions are bluish, compressible, or painful.
A detailed family and health history can help show when the lesions first appeared and whether they have changed over time. This also helps doctors tell telangiectatic glomangioma from more common birthmarks or other vascular skin conditions.
A dermatologist may use a handheld lighted magnifier to examine structures just under the skin surface. This can help guide whether the lesion behaves more like a vessel-related growth or another type of skin tumor.
Ultrasound or magnetic resonance imaging may be used when a lesion is deep, large, or causing significant pain. These imaging findings help show the lesion's extent and whether nearby tissues are involved.
How is Telangiectatic glomangioma diagnosed?
Telangiectatic glomangioma is usually diagnosed by a skin specialist after looking closely at the spots, asking when they started, whether they are painful when pressed, and whether others in the family have had similar blue, purple, or red skin bumps. If the area seems deeper or the diagnosis is uncertain, imaging such as an ultrasound or MRI can help, and a small tissue sample, called a biopsy, may be checked under a microscope to confirm it. Genetic testing may be offered when there are many spots or a strong family history, but it usually supports the diagnosis rather than replacing the exam and biopsy.
Stages of Telangiectatic glomangioma
Telangiectatic glomangioma does not have defined progression stages. This is because it is usually identified as a type of blood vessel and glomus cell skin lesion, rather than a condition that predictably moves from one stage to another over time. Doctors usually start with a conversation about when the spot appeared, whether it has changed, and whether there is pain, tenderness, or bleeding, since these can overlap with the early symptoms of telangiectatic glomangioma. Diagnosis is usually based on a skin exam, and sometimes imaging or a small tissue sample is needed to confirm what it is and to monitor any change.
Outlook and prognosis
The outlook for telangiectatic glomangioma is generally excellent because these lesions are benign and often remain stable or grow only slowly over time. When a lesion is painful, bleeds, or causes cosmetic concern, surgical removal is usually curative, although recurrence can occur if it is not completely excised or if a person has multiple glomangiomas. Some people continue to have intermittent tenderness or develop additional lesions, particularly in familial or multifocal forms, but this does not usually affect overall health or life expectancy. Malignant transformation is extraordinarily rare, and death from telangiectatic glomangioma itself would be exceptionally uncommon. Overall prognosis is driven mainly by symptom burden, lesion location, and whether complete treatment is feasible.
Long-term effects
For many living with telangiectatic glomangioma, the main long-term effects involve the skin and the tissues just under it, rather than damage to major organs. Over time, daily routines may be affected when spots become more noticeable, more numerous, or tender with pressure. Long-term effects vary widely, so some people have only a few stable areas while others develop broader clusters over the years.
New spots can appear gradually over time, and existing ones may slowly enlarge or become more raised. This often becomes more noticeable from childhood into adult life, although the pace varies from person to person.
Many people with telangiectatic glomangioma develop tenderness or aching when an area is pressed, bumped, or rubbed by clothing. For many, this can mean discomfort from simple moments like leaning on an elbow or wearing a tight waistband.
The affected areas often stay dark red, blue, or purple and can look more prominent over the years. Some may find that clusters become more uneven or thicker, especially in areas exposed to repeated friction.
When lesions sit near joints, on the hands, or on the feet, they can make certain movements uncomfortable. This may affect grip, walking, exercise, or jobs that involve kneeling, standing, or repeated pressure on one area.
How is it to live with Telangiectatic glomangioma?
Living with telangiectatic glomangioma often means living with soft, bluish-purple skin spots or raised areas that can be tender when pressed, bumped, or after standing for long periods, so daily choices like clothing, exercise, and even where you sit can take a bit more planning. For many people, the condition is physically mild but emotionally tiring, especially if the marks are visible or if pain flares unpredictably, and the experience can vary widely depending on how many areas are affected and where they are on the body. Family members or partners may not see the discomfort at first, but they often become part of the routine too, helping with practical adjustments, offering reassurance about appearance concerns, and supporting decisions about when to seek treatment for pain or bothersome lesions.
Treatment and drugs
Telangiectatic glomangioma is usually treated based on how many skin spots there are, where they are, and whether they cause pain, bleeding, or bother with daily life. Small or isolated growths can often be removed with a minor procedure, while some people with larger or multiple areas may be offered laser treatment or other methods to reduce symptoms and improve appearance. Treatment plans often combine several approaches. Pain relief may help when lesions are tender, but medicines do not usually remove telangiectatic glomangioma itself. Because these growths are typically benign, treatment is often focused on comfort and function, and a skin specialist can explain the best options for telangiectatic glomangioma in your situation.
Can you cure Telangiectatic glomangioma?
There is no overall cure for telangiectatic glomangioma at this time. Treatment can often help with painful or bothersome spots by removing them or shrinking them, usually with surgery, laser treatment, or other local procedures. For many living with this condition, treatment is mainly about easing symptoms and improving comfort or appearance, and new spots can sometimes appear over time.
Non-drug treatment
Living with telangiectatic glomangioma often means dealing with tender skin bumps, discomfort when clothing rubs the area, or pain after a minor knock. Treatment is usually focused on symptom relief and improving day-to-day comfort, since many lesions are benign and do not need urgent treatment. Not every approach works the same way, so care depends on how many spots are present, where they are, and how much they affect daily life.
Small telangiectatic glomangioma lesions that are not painful or changing may simply be monitored over time. Regular skin checks help track growth, new tenderness, bleeding, or color change.
Surgery can be the best option for a single painful or bothersome lesion, especially if it catches on clothing or hurts with pressure. Removing the spot may give lasting relief when the lesion is well defined.
Laser therapy may help some people with telangiectatic glomangioma, especially when there are several shallow skin lesions. It is usually used to reduce visibility or discomfort rather than cure every lesion completely.
Sclerotherapy involves injecting a solution into selected lesions to help shrink them. This is used more often for certain vascular-looking lesions and may be considered when surgery is not practical.
Your genes may have an impact on how drugs work for you
For people living with telangiectatic glomangioma, treatment is usually based more on where the spots are, how many there are, and whether they hurt than on inherited differences in how the body handles medicine. At this time, there are no well-established genetic findings that clearly guide which pain medicines, numbing medicines, or other common treatments will work better or cause more side effects for this condition. In other words, your genes may explain why these growths happen in some families, but they do not yet play a clear, routine role in choosing medication for telangiectatic glomangioma.
Pharmacological treatments
For telangiectatic glomangioma, medicines are usually used to ease symptoms or support treatment rather than make the growth go away. Many living with telangiectatic glomangioma do not need regular drug treatment, especially if the spot is small and not painful. When treatment is needed, doctors often focus on pain relief, numbing medicine for procedures, and in selected extensive vascular cases, a drug called sirolimus. Not everyone responds to the same medication in the same way.
Acetaminophen or nonsteroidal anti-inflammatory drugs such as ibuprofen may help if telangiectatic glomangioma becomes tender after pressure, exercise, or minor bumps. These medicines treat discomfort but do not shrink the lesion.
Local anesthetics such as lidocaine are often used before biopsy, laser treatment, or surgical removal so the area can be treated with less pain. For many, this can mean a more manageable experience when treatment is needed.
Sirolimus has been used in some people with larger or more complex vascular malformations, including glomus-related lesions, when symptoms are hard to control. It is not a routine first treatment for a small telangiectatic glomangioma, and careful specialist monitoring is needed because of possible side effects.
If a lesion is removed or treated with a procedure, doctors may briefly recommend pain medicine and sometimes an antibiotic only if there is a concern about infection. Sometimes medicines are taken short-term for recovery, while the main treatment is the procedure itself.
Genetic influences
When telangiectatic glomangioma appears in more than one family member, it often raises questions about inheritance. Family history is one of the strongest clues to a genetic influence. Researchers have linked some glomangiomas, especially when there are multiple skin lesions, to changes in a gene called GLMN. These changes can be passed from a parent to a child, but the number of spots, their size, and whether they hurt can vary a lot even within the same family. For people with a single telangiectatic glomangioma and no relatives with similar lesions, a genetic cause is less clear, and the lesion may be sporadic rather than inherited. If several relatives are affected or the lesions started early, a genetics specialist can help answer whether telangiectatic glomangioma is hereditary in your family and whether testing might be useful.
Is Telangiectatic glomangioma genetic?
Genetics are important in telangiectatic glomangioma, because some cases are linked to inherited changes in the GLMN gene. Many living with telangiectatic glomangioma have no known family history, so genetic testing may or may not be useful.
Having a genetic risk is not necessarily a diagnosis
Changes in genes, often called genetic variants, are a normal part of human biology and are common across the general population. Most of these variants do not directly affect health and simply reflect natural human diversity. For many genes, having a variant associated with a condition suggests a possible link rather than a definite diagnosis, especially when several genes and environmental factors are involved. In some situations, though, one well-understood variant in a particular gene can be enough to confirm a diagnosis.
Pharmacogenetics—how genetics influence drug effects
For many people with telangiectatic glomangioma, the main treatment questions are whether a painful or visible spot should be removed, treated with a laser, or simply watched. In some families, these growths are linked to an inherited change in the GLMN gene, which can make multiple spots more likely and can help explain why new ones appear over time. That information can guide care, because doctors may check for other lesions, talk about whether relatives could also be affected, and plan treatment one area at a time rather than expecting a pill to control all of them. Genetics is only one factor, though, because treatment choices also depend on where the lesion is, how much it hurts, whether it bleeds, and how deep it extends into nearby tissue. At this point, there are no well-established gene-targeted drugs or routine pharmacogenetic tests that specifically tell doctors which medicine will work best for telangiectatic glomangioma. If the diagnosis is unclear or there are many lesions, genetic testing for telangiectatic glomangioma may sometimes help confirm the cause and support family counseling.
Interactions with other conditions
Most people with telangiectatic glomangioma are dealing with a skin or soft-tissue problem rather than a condition that directly causes other diseases throughout the body. It can, however, overlap with other vascular birthmarks or vessel-related conditions, which may make a painful blue-purple spot or easy bleeding harder to sort out at first. Doctors call it a comorbidity when two conditions occur together, but in telangiectatic glomangioma there is no strong evidence that it commonly leads to major heart, lung, or autoimmune disease. In everyday life, this may matter when early symptoms of telangiectatic glomangioma look similar to other causes of skin nodules, such as venous malformations or other benign growths, and that can affect how quickly the right diagnosis is made. If someone also has a bleeding disorder, takes blood thinners, or has frequent skin trauma, the lesion may bruise or bleed more easily, so it is worth discussing the full medical picture with a clinician.
How genes can cause diseases
Humans have more than 20,000 genes, each carrying out one or a few specific functions in the body. One gene instructs the body to digest lactose from milk, another tells the body how to build strong bones and another prevents the body's cells from beginning to multiply uncontrollably and developing into cancer. As all of these genes combined are the building instructions for our body, a defect in one of these genes can have severe health consequences.
Through decades of genetic research, we know the genetic code of any healthy/functional human gene. We have also identified that in certain positions on a gene, some individuals may have a different genetic letter from the one you have. We call these hotspots "Genetic Variations" or "Variants" in short. In many cases, studies have been able to show that having the genetic letter "G" in the position makes you healthy, but having the letter "A" in the same position disrupts the gene function and causes a disease. Genopedia allows you to view these variants in genes and summarizes all that we know from scientific research, which genetic letters (Genotype) have good or bad consequences on your health or on your traits.
What other conditions can cause similar symptoms to Telangiectatic glomangioma?
Other conditions that can cause similar-looking blue, red, or purple skin spots or small painful lumps include venous malformations, hemangiomas, angiokeratomas, and the more usual type of glomus tumor. If the spot bleeds easily or seems to grow fast, doctors may also consider a pyogenic granuloma, which is a small overgrowth of blood vessels, or less often another skin growth that needs closer checking.
History
People living with telangiectatic glomangioma often spend years thinking they simply have unusual blue or purple skin spots that bruise easily or hurt when pressed. A child may have a small patch on the arm or leg that slowly darkens over time, or an adult may only seek care after noticing that several tender bumps have appeared in the same area. Because these marks can resemble other blood vessel or skin growths, the condition was not always easy to recognize in the past.
Early doctors first described related growths by what they looked and felt like under the skin, especially their color, tenderness, and tendency to appear in clusters. Over time, the way the condition has been understood has changed, and telangiectatic glomangioma came to be separated from other similar skin lesions as pathologists learned more from examining tissue under the microscope. This helped show that these lesions were not just ordinary birthmarks or simple vein problems, even though they can look that way at first glance.
As medical science evolved, doctors also recognized that telangiectatic glomangioma belongs to a broader group of glomus-related growths, while still having its own pattern of larger, more visible, often bluish lesions with widened surface blood vessels. In recent decades, better imaging, improved skin pathology, and growing awareness among dermatologists have made diagnosis more accurate. Researchers later identified a genetic cause in many families, which helped explain why some people develop multiple lesions and why these spots can run in relatives, but the history of telangiectatic glomangioma still begins with careful observation of changes people could see and feel in everyday life.
That history matters today because early symptoms of telangiectatic glomangioma can still be mistaken for other skin conditions. Knowing how recognition has changed over time helps explain why getting the right diagnosis may take a while, and why a specialist may be needed when lesions are painful, increasing in number, or causing concern.